Frontiers in Immunology (Feb 2022)
Prevalence of Pure Red Cell Aplasia Following Major ABO-Incompatible Hematopoietic Stem Cell Transplantation
- Panpan Zhu,
- Panpan Zhu,
- Panpan Zhu,
- Panpan Zhu,
- Yibo Wu,
- Yibo Wu,
- Yibo Wu,
- Yibo Wu,
- Dawei Cui,
- Jimin Shi,
- Jimin Shi,
- Jimin Shi,
- Jimin Shi,
- Jian Yu,
- Jian Yu,
- Jian Yu,
- Jian Yu,
- Yanmin Zhao,
- Yanmin Zhao,
- Yanmin Zhao,
- Yanmin Zhao,
- Xiaoyu Lai,
- Xiaoyu Lai,
- Xiaoyu Lai,
- Xiaoyu Lai,
- Lizhen Liu,
- Lizhen Liu,
- Lizhen Liu,
- Lizhen Liu,
- Jue Xie,
- He Huang,
- He Huang,
- He Huang,
- He Huang,
- Yi Luo,
- Yi Luo,
- Yi Luo,
- Yi Luo
Affiliations
- Panpan Zhu
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Panpan Zhu
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Panpan Zhu
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Panpan Zhu
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Yibo Wu
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Yibo Wu
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Yibo Wu
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Yibo Wu
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Dawei Cui
- Department of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Jimin Shi
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Jimin Shi
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Jimin Shi
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Jimin Shi
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Jian Yu
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Jian Yu
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Jian Yu
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Jian Yu
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Yanmin Zhao
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Yanmin Zhao
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Yanmin Zhao
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Yanmin Zhao
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Xiaoyu Lai
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Xiaoyu Lai
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Xiaoyu Lai
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Xiaoyu Lai
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Lizhen Liu
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Lizhen Liu
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Lizhen Liu
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Lizhen Liu
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Jue Xie
- Department of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- He Huang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- He Huang
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- He Huang
- Institute of Hematology, Zhejiang University, Hangzhou, China
- He Huang
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Yi Luo
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Yi Luo
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Yi Luo
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Yi Luo
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- DOI
- https://doi.org/10.3389/fimmu.2022.829670
- Journal volume & issue
-
Vol. 13
Abstract
BackgroundPure red cell aplasia (PRCA) is one of the important complications in major ABO-incompatible allogeneic hematopoietic stem cell transplantation (HSCT). The established pathogenic factor of PRCA is the persistence of high anti-donor isohemagglutinins. As previously verified, the conditioning regimen and donor type were the factors associated with the development of PRCA in the small-sized studies. Currently, the prevalence, risk factors, and prognosis of PRCA are still worth studying to provide evidence.MethodsWe conducted a prospective nested case-control study to determine the prevalence, donor-related factors, and the outcomes of PRCA following major ABO-incompatible transplantation. A total of 469 patients who underwent ABO-incompatible grafts were observed.ResultsNone of the patients were diagnosed with PRCA with minor or bidirectional ABO-incompatible HSCT. Thirteen of the187 patients (7%; 95% confidence interval [CI], 3.9%–11.9%) developed PRCA following major ABO-incompatible HSCT. Eleven of the 13 patients with PRCA recovered entirely. Donor type was an independent factor associated with post-HSCT PRCA (odds ratio [OR]=0.030; 95% CI, 0.003–0.321; P=0.004). The cumulative incidence rates of post-HSCT PRCA in the context of major ABO-incompatible HSCT were 0.8%, 13.1%, and 27.2% for the haploidentical donor (HID), unrelated donor, and matched related donor, respectively. No significant influence of PRCA on transplantation outcomes was observed.In conclusion, post-HSCT PRCA is a rare and less threatening complication in major ABO-incompatible HSCT. The majority of patients with PRCA could recover. Additionally, HIDs for recipients may have a low risk of post-HSCT PRCA. This trial was registered at www.chictr.org.cn (#ChiCTR2000041412).
Keywords
- pure red cell aplasia
- major ABO-incompatible transplantation
- haploidentical donor
- allogeneic hematologic stem cell transplantation
- isohemagglutinin
